Provider Demographics
NPI:1528236262
Name:ROWE, KRISTINA (PMHNP)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:ROWE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:IRONTON
Mailing Address - State:OH
Mailing Address - Zip Code:45638-1578
Mailing Address - Country:US
Mailing Address - Phone:740-532-3534
Mailing Address - Fax:740-532-4859
Practice Address - Street 1:1408 CAMPBELL DR
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-2301
Practice Address - Country:US
Practice Address - Phone:740-534-9202
Practice Address - Fax:740-532-4777
Is Sole Proprietor?:No
Enumeration Date:2008-02-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP12922363LF0000X, 363LP0808X
KY5551P363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000583796OtherANTHEM BCBS
OHNP 12922OtherOH LICENSE
OH2824215Medicaid
KY000000604049OtherANTHEM BCBS
KY7100034870Medicaid
KY000000551448OtherANTHEM BCBS
KY000000609853OtherANTHEM BCBS
KY000000551448OtherANTHEM BCBS
KY7100034870Medicaid
OH2824215Medicaid
KY00934006Medicare PIN